This is not about iatrogenic, as the name might suggest. Of course, the activities in the field of health can be destroyed by iatrogenic adverse events that are of particular concern when health is not essential. Returning to the promise made in the previous post, to discuss the Dartmouth Atlas Project, programs made by the Dartmouth Institute of Health Policy and Clinical Practice at Dartmouth University in the United States. John Wennberg, the founder, urged other countries to follow suit in an article published in the British Medical Journal 26 March 2011 (Vol. 342, pages 687-690, abstract available in English only). He noted with satisfaction that the English edition of the atlas in a change in health care NHS, which shows how the public can demonstrate their ability to make data available to the public the data management of the regional variations in medical practice.
Dartmouth Atlas Project published openly on the Internet, these health care, health insurance, which covers the entire North American population of 65. The project defines the change in practice: hospital, health expenditure per capita distribution of resources in each area. The project has shown that the use of health services in the United States was not, or not significantly correlated with health or patient preference. Wennberg defines three categories of services.
A. Effective assistance. If the benefits clearly outweigh the risks, the use of attention should be 100% in accordance with the precepts of evidence-based medicine: the inability to ensure that rates for all affected population means that health care services to the fullest.
Two. Orientation-sensitive health care. If at least two valid alternative treatment strategies are available. The choice of treatment may vary depending on the patients to make informed decisions based on the best clinical evidence and may be significant changes in relation to the significant difference in medical opinion.
Three. Nutrition, care for sensitive skin. This applies to the number of visits to doctors, hospitalization, and further investigation, which depend on the capacity of local health care system. The problem here is that there is no correlation in the research project Dartmouth between these figures and health indicators such as quality of care mortality, morbidity, or health.
Effective aid should be available equally to all populations. It is not, and there are many examples of treatment is not recommended to be uniform across the country (although the entire population of North America are concerned is covered by Medicare). For example, immunization coverage against pneumococcal disease for older people is less than 45% in some areas, while in others it is more than 95%. Another example is a five-fold difference between the highest and lowest coverage for the treatment recommended for diabetics.